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Registration Form & Mailing Instructions

February 18-23, 2018
"Topic to be announced"

To apply for this intensive, submit the following items along with your completed registration form and payment-in-full. Please submit all items together at the time of application.

  • A recent head & shoulder, individual color photo.
  • For new students, your typed thoughtful responses to the questions below on a separate paper, limiting your answers to 1-2 paragraphs per question.

We are sorry that incomplete applications cannot be accepted.

New Students: If this is your first intensive with Rosalyn and Ken, please provide the following additional typed information with your registration, limiting your answers to 1-2 paragraphs per question.

  • Do you have previous workshop experience with Rosalyn and Ken (where, when, and what subject)?
  • Please indicate your spiritual background. How have you evolved and where are you now? What work have you studied and with whom?
  • References - Please share with us how you found our community.

Registration Form

Name_______________________________________________

Address_____________________________________________

City________________________________________________

State/Prov_____________Zip____________________________

Home Phone__________________________________________

Work phone__________________________________________

Email_______________________________________________

Name for ID Tag______________________________________

Emergency Contact Name__________________________________

Emergency Contact Phone#__________________________________

$650 Early Bird Fee (Payment due by Jan 14)
$750 Tuition Fee

Check # ______ payable to HLCC and/or

MC Visa Disc AMEX

CC#____________________________________ Security Code (3 digit code on back):______   Ex. Date:__________

To register for this workshop please fill out the form above and mail it
along with your payment, AND color photo to the following address.

Shannon Winsky
c/o HLCC
 261 E. Alegria Ave #12
Sierra Madre, CA 91024

OR,

Email s.winsky3@gmail.com to register with email,
please copy and past this registration filled out completely.

Questions? Please feel free to phone Shannon at (626) 602-4642.